Dry Powder Inhaler

DPIs are breath-activated devices that deliver micronized drug particles to the lungs.  Carrier particles like lactulose or glucose are utilized to adsorb the drug, which imparts the proper aerodynamic properties for delivery.  The drug is administered after a drug reservoir is punctured prior to inhalation.,  It is necessary to have strong inspiratory flow rates between 30-60 L/min in order to separate and aerosolize the drug. Examples of DPIs are Advair© Diskus and Serevent© Diskus.  DPIs should not be washed as this may lead to aggregation and clumping of the medication.  The mouthpiece can be wiped with a clean, dry cloth as needed to prevent excessive drug accumulation.  The device should also be stored in a dry, arid space as the humidity can lead to clumping of medication. Advantages of DPIs are increased pulmonary deposition, decreased oropharynx deposition, reliable dose administration, ease of coordination with breathing, and ease of operation. Disadvantages of DPIs are that humidity compromises drug integrity, and the device may be unsuitable for young children or other patients unable to generate the necessary high inspiratory flow rate.  Children can be tested to see if they are appropriate for DPI by using a tissue.  If the child can hold the tissue to his or her mouth for 5 seconds through the force of inhalation, then they can generate enough inspiratory force to properly use a DPI.

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